Purpose: The objective of this study was to investigate the relationships between sleep quality, fatigue, depression and health promoting behavior by shift-work patterns in university hospital nurses. Methods: A cross-sectional, descriptive survey was conducted using a convenient sample. The self-administered questionnaires were given to 165 nurses (shift workers 91, non-shift workers 74) employed in two university hospital located in Seoul and Gyeunggi-do. Data were collected from February to March, 2010. Results: The shift workers showed significantly lower sleep quality and health promoting behavior, and higher fatigue than non-shift workers. There were significant correlations between fatigue, depression and health promoting behavior in shift workers. There were significant correlations between sleep quality, fatigue, depression and health promoting behavior in non-shift workers. In multiple linear regression analysis, after controlling for total work experiences, predictor of health promoting behavior in shift workers was only fatigue (β=-.29, p